Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Breast Neoplasms

Breast Diseases

Skin Diseases

Lipid Regulating Agents

All Drugs and Chemicals

Simvastatin

Anticholesteremic Agents

Hypolipidemic Agents

Antimetabolites

Hydroxymethylglutaryl-CoA Reductase Inhibitors

Enzyme Inhibitors

The group received standard treatment with the oral administration of Simvastatin

The group received standard treatment with the oral administration of Placebo

The administration of Simvastatin 40 mg in addition to neoadjuvant chemoterapy CAF

Simvastatin 40mg

The administration of Placebo capsule 40 mg in addition to neoadjuvant chemoterapy CAF

Placebo oral capsule

Nurjati Chairani Siregar, MD

Baju Adji

Filipus Dasawala, MD

Hanifah Hasan, MD

Muhammad Rizki Kamil, MD

Introduction: Neoadjuvant chemotherapy (NACT) has been the standard therapy for treating patients with locally advanced breast cancer (LABC). Doxorubicin-based regimen showed a clinical response for 70-80%. However, the cardiotoxicity from it was not tolerable. Simvastatin acts synergistically with doxorubicin against MCF-7 cells, through downregulation of the cell cycle or induction of apoptosis. Also, it alleviates doxorubicin cardiotoxicity by attenuating ER stress and activating the Akt pathway. Hmgcris a new pathway mediating doxorubicin-induced cell death, and cholesterol control drugs combined with doxorubicin could enhance efficacy and reduce side effects. This study is conducted to see the combination simvastatin and CAF would increase the NACT response and surgical margin of LABC patients.

Methods: This study was a double-blind, randomized placebo-controlled trial, conducted in dr. Cipto Mangunkusumo General Hospital and Koja General Hospital. A total of 70 LABC patients were assessed for eligibility. Patients received either a combination of CAF-Simvastatin (40 mg/day) or CAF-Placebo. The biopsy was taken pre-NACT to make the histopathological diagnosis and examine the expression of HMG-CoA Reductase (Hmgcr) and P-glycoprotein (P-gp). Patients were evaluated for the clinical response after 3 cycles. If the response was positive, patients will proceed to surgery. Then, the post-operative specimen will be reviewed for the pathological response. However, if it was a negative response, patients will be given 2nd line NACT.

Backgrounds Neoadjuvant chemotherapy (NACT) which is followed by surgery is now a standard therapy in the local advanced breast cancer (LABC) since it was introduced 50 years ago, increasingly being used in early-stage LABC patients. Some NACT studies in RSCM use a doxorubicin-based regimen, giving a 70-80% partial response, but do not require a complete response both clinically and pathologically. The NACT response was 80% with a complete clinical response of 36%. The complete pathological response obtained after NACT is the prognosis of a replacement marker both overall and disease-free survival in the LABC. The purpose of giving NACTis to increase tumor resectability and de-escalation surgery and kill micrometastasis which will increase the length of disease-free and life expectancy of the patient. New tumor margins causing post-NACT tumor shrinkage can be used as surgical margins.

Doxorubicin-based chemotherapy is the most commonly given chemotherapy for NACT as well as entering the first line of the National Formulary. However, side effects are limited from drug resistance side effects that can cause cardiomyopathy and heart failure. One of the factors that influence doxorubicin resistance is the presence of efflux pumps such as P-glycoprotein (P-gp) on the cell surface. While the effects of toxicity arise due to the formation of reactive oxygen species (ROS) and the presence of free radicals. Efforts to improve the efficacy of the combination of chemotherapy currently being used with targeted therapies such as anti-HER-2 and bevacizumab, but have a high enough toxicity and are expensive and not included in ForNas. Likewise, some drugs that have been tested in vitro as P-gp inhibitors/modifiers, but failed in clinical trials because of ineffectiveness and greater side effects on the kidneys and heart. Some previous studies have confirmed that simvastatin is a potential ABCB1 / P-gp inhibitor.

Statins are the most widely used anti-hypercholesterolemia in the world, through inhibition of 3-hydroxy-3-methylglutaryl coenzyme-A reductase (Hmgcr) which is an enzyme that limits the use of the mevalonate pathway that can be used as intracellular cholesterol. Besides having pleiotropic effects, statins also have anti-tumor effects. At this time, statins have received approval as a potential anti-tumor agent because several epidemiological studies have agreed on the relationship between statin use and reducing the risk of recurrence of LABC after adjuvant therapy. Some preclinical studies show that statins can decrease breast cancer cell proliferation and induce apoptosis in various experimental models. results from pre-operative "window-of-opportunity" clinical trials on LABC so that statins can reduce tumor proliferation and induce apoptosis. Reports in the RSCM get simvastatin 40 mg for 4 weeks for neoadjuvant reduce the proliferation index in the LABC by 53.3% and inhibit the increase in LABC cells through the Rho / Rock pathway. Although several studios of statin antitumor activity have been carried out, the role of statins in oncology has not yielded satisfactory results or controversies and provides heterogeneous responses depending on the molecular identity and tumor type malignancy. The results of a clinical preliminary study indicate that giving a single statin is not as effective as an anti-cancer because it requires large effects and large side effects.

Several in vitro studies and animal models show that the combination of statins can increase the accumulation of intra-cell chemotherapy so that the effects of potentiation of chemotherapy arise. The administration of a combination of doxorubicin statins increases the potential for anti-cancer effects through the accumulation of doxorubicin in cancer cells, causing the potential for DNA damage, inhibition of proliferation, and induction of apoptosis. statins can also protect cardiotoxic induced by doxorubicin if it is given pre-therapy in mice. With a variety of anti-tumor mechanisms as well as the enormous benefits and potential addition of statins that can be well-tolerated, safe, and inexpensive. However, until now the effects of antiproliferation synergy and induction of apoptosis combination of simvastatin and doxorubicin in LABC patients are not well known. This study aims to determine the efficacy, tolerability, and safety of simvastatin combination and CAF chemotherapy as neo-advanced therapy in LABC patients. The use of this combination is expected to improve clinical and pathological responses as well as surgical margins while providing cardioprotection effects, so as to provide the best service with high oncological value.

Methods

1. Subject and study design This research is a double-blind, placebo-controlled clinical trial conducted at Dr. Cipto Mangunkusumo General Hospital and Koja General Hospital from January 2018 to September 2019. Eligible patients are patients with grade IIIA to IIIC invasive breast cancer that is histologically proven. A total of 60 LABC patients were included in this study. Participants received a combination of NACT CAF and Simvastatin (40 mg / day) (n = 30) or placebo (n = 30). Besides being used to make a histopathological diagnosis, samples were taken by biopsy before NACT, examined for the expression of HMG-CoA Reductase (HMGCR) and P-glycoprotein (P-gp). Participants were evaluated for the clinical response after 3 NACT cycles. If it gives a complete or partial response, then the patient will proceed to surgery. Then, the postoperative specimen will be reviewed for a pathological response. However, if it is stable or progressive, the patient will be given a 2nd line NACT.
2. Tumor assessment The primary outcome was clinical response while the secondary outcome was the pathological response, incision boundary, P-gp expression, Hmgcr expression and side effects. The analysis was performed on the population per protocol. Clinical response assessment uses WHO 1979 criteria. Pathological responses of tumors are evaluated according to the Miller-Payne scoring system. MPG classification is used to evaluate the relevance between pathological response and clinical response. The incision boundary assessment is performed using histopathological tissue incisions depending on the surgical margins of the tumor on the medial, lateral, cranial, caudal, and baseline sides of the tumor; based on the size of the new tumor. Histopathological results will determine whether the level is free from the tumor or not based on the size of the new tumor. Disease assessment is carried out by investigation after 3 NACT cycles. Side effects were assessed during treatment and for 7 days after the last treatment dose and assessed using CTCAE 3.0.
3. Biomarker assessment Estimation of P-glycoprotein (Pgp) and Hmgcr expression was seen under a microscope from a sample after a core biopsy was performed before starting chemotherapy. P-gp expression was interpreted based on the percentage of p-glycoprotein positive cells in the total cell population (low = 0%, 1+ = 1-19%, and 2 + = 20-100% positive cells). Hmgcr expression is interpreted based on the percentage of Hmgcr positive cells in the total cell population (negative = 0%, 1+ = 1-10%, 2+ = 11-50%, 3+ =\> 51-100% positive cells)..
4. Statistical analysis The main results in this study were clinical responses based on WHO 1970 criteria. ORR values in this study were calculated from the ratio of the number of patients who showed a response (complete and partial) to the total number of patients and were analyzed using the Pearson Chi-Square Test. Secondary outcomes in the form of pathological responses based on GMP and incision boundaries were analyzed using Fisher's Exact Test. Bivariate analysis of clinicopathological variables and molecular biology with the therapeutic response using the Continuity Correction Test and the Fischer's Exact Test. The results of the bivariate analysis with p\> 0.25 were performed multivariate analysis using the Logistic Regression Test. The analysis was performed with the help of a computer using the SPSS 23 program. Differences were stated to be meaningful and obtained p values \<0.05.

Simvastatin Effect in Combination With Neoadjuvant Chemotherapy to Clinical Response and Tumor-Free Margin in Locally Advanced Breast Cancer

Combination of CAF and Simvastatin Improves Response to Neoadjuvant Chemotherapy and Increases Tumor-Free Margin in Locally Advanced Breast Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial

Clinical Response is measured using WHO 1979 criteria.

1. Complete Response (CR): Disappearance; confirmed at 3 months
2. Partial Response (PR): 50% decrease; confirmed at 3 months
3. Stable Disease(SD): Neither PR nor PD criteria met
4. Progressive Disease (PD):25% increase; no CR, PR, or SD documented before increased disease

Evaluation of the MP system is based on the reduction of tumor cellularity before and after chemotherapy, divided into:

1. Grade 1 ie there is no change or reduction in cancer cells.
2. Grade 2: reduction of \<30% cancer cells
3. Grade 3: reduction of cancer cells between 30-90%
4. Grade 4: reduction of \> 90% cancer cells
5. Grade 5 is that there are no residual cancer cells. Grade 4 is categorized as partial pathology response. Grade 5 is categorized as a complete pathology response

histopathologically the tissue to the tumor incision limit on the medial, lateral, cranial, and caudal sides along with the tumor base; based on the size of the new tumor. Hisopathologically assesses the extent of incision free or not tumor based on the size of the new tumor.

Indonesia University

Lecturer, Staff of Oncology Division of Department of Surgery, Principal Investigator

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Symptoms and General Pathology

Prostatic Neoplasms

Facies

Genital Neoplasms, Male

Urogenital Neoplasms

Genital Diseases

Genital Diseases, Male

Urogenital Diseases

Prostatic Diseases

Male Urogenital Diseases

The patients will undergo radical prostatectomy with nerve sparing decisions based on the results of the NeuroSAFE technique

Frozen section analysis of the posterolateral surface of the prostate to guide nerve sparing decisions.

NeuroSAFE procedure

The LaserSAFE procedure is performed using an FCM called the Histolog® scanner developed by Samantree® which can be placed within the operating room. The Histolog® scanner produces digital images with high, micrometre-range resolution and enables the visualization of tissue microstructures down to the cellular level.

LaserSAFE procedure

Greg Shaw

Ricardo Almeida Magana

Prostate cancer is the most common solid cancer affecting male patients worldwide. When diagnosed early, it can usually be cured with surgery (radical prostatectomy), but this procedure is associated with side effects such as urinary incontinence and erectile dysfunction. If the nerves that surround the prostate are left intact (nerve-sparing), the risk of developing these side effects decreases. However, since these nerves are in intimate contact with the prostate there is a chance of leaving cancer cells behind, with the subsequent need for additional treatments. Sadly, the current methods surgeons use to select patients who can safely be offered nerve-sparing are not very accurate in predicting where the tumour is extending outside the prostate.

NeuroSAFE is a technique that can inform the surgeon if there are tumour cells on the surface of the prostate and indicate the need for removing more tissue during the same operation. However, it requires a specialised team to process the sample in a reasonable amount of time that does not excessively prolong the surgery. Therefore, many centres are not able to perform it.

A new technology called fluorescence confocal microscopy (LaserSAFE) can be used to examine the surface of the prostate and can identify when cancer is present. Critically, it requires minimal training and resources to produce results in a few minutes and the microscope can be placed in the operating room.

The investigators aim to recruit a group of 20 patients who will undergo radical prostatectomy as a treatment for prostate cancer. The prostate specimen will be analysed using both techniques, but decisions on how much tissue to resect during surgery will depend on the results of NeuroSAFE. This feasibility study will allow us to understand the challenges associated with performing both techniques. This will allow us to plan a larger study to evaluate the accuracy of LaserSAFE.

This trial will be a multi-site, single-blinded, prospective, feasibility study. 20 participants will be recruited from 2 centres that have experience performing the NeuroSAFE technique. Participants will undergo a robotic-assisted radical prostatectomy with nerve-sparing guided by the NeuroSAFE technique. Before the prostate is sent for evaluation the LaserSAFE technique will be used to analyse the corresponding posterolateral surfaces of the prostate. Participating pathologists involved in interpreting the results of NeuroSAFE will be blinded to the LaserSAFE results, to avoid influencing standard patient treatment, management, and progression outcomes after radical prostatectomy.

The investigators aim to recruit a group of 20 patients who will undergo radical prostatectomy as a treatment for prostate cancer. The prostate specimen will be analysed using both techniques, but decisions on how much tissue to resect during surgery will depend on the results of NeuroSAFE.

After LaserSAFE, images are acquired, they will be annotated with the study identifier only. Images will be stored and kept until the end of recruitment. Once all specimens have been evaluated using paraffin analysis, a dedicated meeting with the evaluating pathologist will be carried out. A set of images without any patient identifier will be shown in random order. A purposely built document will allow the pathologist to report the images. This meeting will be repeated with every evaluating pathologist until all images have been analysed.

Study to Evaluate a New Method to Detect Residual Tumours During Surgery for Prostate Cancer Using Confocal Microscopy

A Feasibility Trial to Evaluate Margin Status During Radical Prostatectomy With En-face Fluorescence Confocal Microscopy (LaserSAFE) Compared to NeuroSAFE

There are currently no plans to share individual participant data as this is a feasibility study with low number of participants

Evaluate the feasibility of using the LaserSAFE technique to evaluate margin status during radical prostatectomy compared to the NeuroSAFE technique

Concordance between LaserSAFE and NeuroSAFE recommendation on secondary resection during radical prostatectomy

University College London Hospitals

University College, London

Infusion of Indocyanine Green 0,25 mg/Kg 24h before prostatic surgery

intravenous injection (0,25mg/kg) of the indocyanine green 24h before prostatic surgery.

indocyanine green infusion

Nicolas MOTTET, PhD

Prostate cancer, with more than 70,000 new cases and 8900 deaths a year in France, is a major public health problem. Until 28% of patients treated with surgery will present a positive surgical margin resulting in an incomplete clearance of the tumoral process and exposing so the patient at a local, systemic recurrence and increased morbidity. An increasing number of international publications have shown (ICG) was interesting for the detection of the sentinel lymph node, in the surgery of tumors of type hepatocarcinoma and liver metastases from colorectal diseases, but also in the surgery of the kidney, bladder or breast. ICG has affinity for tumor and tissues around the tumor related to micro-vascular histology for a localized and specific deposit (EPR effect).

The detection of ICG 's deposits is now possible with to the use of a device which allow to visualize the infra-red fluorescence (NIR; Near Infra-Red) for objects larger than 0.15 mm. Thanks to this feature, the location of residual tumor tissue when performing a radical prostatectomy could be made much easier.

The ability of ICG to detect a surgical margin positive intraoperatively has never be evaluated. We want to perform a monocentric prospective ex-vivo pilot in order to evaluate the diagnostic performance of fluorescence in the detection of surgical margins compared to pathologic analysis. This study will be conducted in 37 patients operated on for a radical prostatectomy after systemic injection of 0, 25 mg/Kg of ICG 24 h before the surgery. The fluorescence analysis will be performed in the operation room and then specimen will be sent to the laboratory for an analysis as usual. Two pieces of prostate will be prelevated according to a protocol. The histopathological procedure will be performed without knowledge of fluorescence analysis. Except the ICG injection the medical procedure won't be changed.

Interest of Indocyanine Green in Neoplastic Prostatic Tissue

Interest of Indocyanine Green in the Neoplastic Prostatic Tissue Characterization and the Peroperative Surgical Margins Detection During a Radical Prostatectomy.

Sensitivity (true positive) of the fluorescence due to indocyanine green to detect neoplasm tissue in prostatic biopsy compared to histological analysis

Specificity (true negative) of the fluorescence due to indocyanine green to detect neoplasm tissue in prostatic biopsy compared to histological analysis

Centre Hospitalier Universitaire de Saint Etienne

Mouth and Tooth Diseases

Carcinoma

Carcinoma, Squamous Cell

Tongue Neoplasms

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Neoplasms, Squamous Cell

In squamous cell carcinoma of the tongue, complete surgical resection of the tumor

tongue surgery

Christophe ATTENCOURT, MD

In squamous cell carcinoma of the tongue, complete surgical resection of the tumor generally represents the primary treatment strategy. Among factors determining the disease prognostic, the surgical margins status is essential for the continued management of the patient, with or without complementary therapies. Generally, surgical margins are defined using visual and tactile elements. Unfortunately, in 15 to 30 percent of cases, they are defined as positive after histopathological examination, on average 5 to 7 days post-surgery.

Techniques have recently been developed to analyze the cancerous and non-cancerous nature of tissues, using the spectral properties of tumor cells. SpiderMass™ is an instrument equipped with a probe for tissue micro-sampling and real-time molecular profile analysis. It is thus ultimately a tool for anatomopathological decision support, for diagnosis and prognosis of the disease. Used in the operating room, SpiderMass™ could also become an innovative surgical tool to precisely define cancerous areas in situ and the margins status in intraoperative conditions.

Based on the principle of artificial intelligence, the SpiderMass™ machine must initially learn to recognize pathological tissues versus healthy. This project aims to accomplish this first phase of machine learning for squamous cell carcinoma of the tongue.

Tissue samples will be taken from the tumor and the non-tumor areas. Surgical specimens will be taken in a fresh state immediately after surgery, by an anatomopathologist and a pathological anatomy technician. The sample will be analyzed under standard conditions. Two sites will be selected macroscopically (including a tumor area, a dysplasia area, and a non-tumor area).

Spectroscopic Analysis of Tongue Tumor Samples.

Prospective Analysis of Tumor Tissues From the Oral Cavity by SpiderMassTM Spectroscopy

Tumor cells detection in tongue tumor with SpiderMass technique

Université de Lille

Centre Hospitalier Universitaire, Amiens

Prostate cancer conducted for RPVE with curative Intention, biopsies of the prostatic fossa in Magdeburg

Conducted for CE in Male with bladder cancer or other indication for cystectomy but without prostate cancer in Magdeburg or Gronau, biopsies of the prostatic fossa in Gronau

Prostate cancer conducted for ETRARP with curative Intention, biopsies of the prostatic fossa

intraoperative Open surgical biopsies of the prostatic fossa after prostatevesiculectomy in Magdeburg

biopsies of the prostatic fossa in Magdeburg

Open Radical prostatovesiculectomy in Magdeburg

RPVE

Robotassisted Radical prostatovesiculectomy in Gronau

ETRARP

intraoperative endoscopic robotassisted biopsies of the prostatic fossa after prostatevesiculectomy in Gronau

biopsies of the prostatic fossa in gronau

Martin Schostak, Prof.Dr.med.

This project is about the detection of occult tumor cells in surgical margins of radical prostatovesiculectomy by analysing the methylation status of Glutathione S-transferase P 1 (GSTP1). After gland excision specimens are obtained from 9 defined areas of the prostatic fossa. The biopsies are divided into two parts. One part used for histopathological analysis and the other part for moleculargenetic analysis. Results will be correlated e.g. with tumor stage, Gleason Score and prostate specific antigen (PSA).

The prostate-cancer-negative control group with bladder cancer.

This project is about the detection of occult tumor cells in surgical margins of radical prostatovesiculectomy by analysing the methylation status of Glutathione S-transferase P 1 (GSTP1). After gland excision specimens are obtained from 9 defined areas of the prostatic fossa. The biopsies are divided into two parts. One part used for histopathological analysis and the other part for moleculargenetic analysis. Results will be correlated e.g. with tumor stage, Gleason Score and prostate specific antigen (PSA).

The prostate-cancer-negative control group with bladder cancer.

DNA ISOLATION

DNA from biopsies stored by -80°C was isolated by using innuPREP DNA mini Kit (Analytik Jena, Jena, Germany) following protocol 1 of the manufacturer's instructions. DNA was eluted with 50 µl elution buffer. Concentration and purity were analysed by using Nanodrop 2000.

DNA BISULFITE MODIFICATION

DNA was modified by using EpiTect Bisulfite Kit (QIAGEN, Hilden, Germany) according to manufacturer's instructions. Samples were eluted once with 20 µl elution buffer.

QUANTITATIVE METHYLATION SPECIFIC PCR

Methylation status of GSTP1 is analysed by quantitative methylation-specific PCR (Q-MSP) using StepOnePlus Real-Time PCR System and StepOne Software v2.1 from Applied Biosystems (Darmstadt, Germany). Q-MSP was performed in duplicate analysing genes Actin and GSTP1. The primers' and testing probes' sequences used to amplify and detect hypermethylated GSTP1 were: 5'-AgTTgCgCggCgATTTC (forward primer), 5'-gCCCCAATACTAAATCACgACg (reverse primer) and 5'-CggTCgACgTTCggggTgTAgCg (taqman probe), labelled with fluorescence dye FAM. The primers' and testing probes' sequences used to amplify and detect Actin were: 5'-TggTgATggAggAggTTTAgTAAgT (forward primer), 5'-AACCAATAAAACCTACTCCTCCCTTAA (reverse primer),5'-ACCACCACCCAACACACAATAACAAACACA (taqman probe), labelled with fluorescence dye VIC.

The Q-MSP was carried out at 50°C for 2 min., 95°C for 15 min. followed by 50 cycles of 95°C for 1s and 60°C for 1 min. As a positive control bisulfite-converted DNA of DU145 and LNCap were used. Blank reactions with destillated water, which replaced DNA, served as negative control (NTC).

Intraoperational Prostate Loge Biopsies (iPROLOGX) After Radical Prostatovesiculectomy

Intraoperational Prostate Loge Biopsies (iPROLOGX) After Radical Prostatovesiculectomy (RPVE) in Prostate Cancer (PCA) Patients for Molecular Tumor Marker Analysis

Methylation status of GSTP1 is analysed by quantitative methylation-specific PCR (Q-MSP)

Histopathology of prostate fossa biopsies (Prostata cancer positive or negative)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Simvastatin Effect in Combination With Neoadjuvant Chemotherapy to Clinical Response and Tumor-Free Margin in Locally Advanced Breast Cancer	NCT04418089	Breast Cancer Chemotherapy Ef...	Simvastatin 40m... Placebo oral ca...	-	Indonesia University
Study to Evaluate a New Method to Detect Residual Tumours During Surgery for Prostate Cancer Using Confocal Microscopy	NCT06398470	Prostate Cancer	NeuroSAFE proce... LaserSAFE proce...	18 Years -	University College, London
Interest of Indocyanine Green in Neoplastic Prostatic Tissue	NCT02260349	Prostatic Neopl...	indocyanine gre...	18 Years -	Centre Hospitalier Universitaire de Saint Etienne
Spectroscopic Analysis of Tongue Tumor Samples.	NCT05104619	Mass Spectrosco... Molecular Profi... Surgical Margin... Squamous Cell C... Oral Cavity Tongue	tongue surgery	18 Years -	Centre Hospitalier Universitaire, Amiens
Intraoperational Prostate Loge Biopsies (iPROLOGX) After Radical Prostatovesiculectomy	NCT02460861	Prostate Cancer	biopsies of the... RPVE ETRARP CE biopsies of the...	-	University of Magdeburg
Simvastatin Effect in Combination With Neoadjuvant Chemotherapy to Clinical Response and Tumor-Free Margin in Locally Advanced Breast Cancer	NCT04418089	Breast Cancer Chemotherapy Ef...	Simvastatin 40m... Placebo oral ca...	-	Indonesia University
Study to Evaluate a New Method to Detect Residual Tumours During Surgery for Prostate Cancer Using Confocal Microscopy	NCT06398470	Prostate Cancer	NeuroSAFE proce... LaserSAFE proce...	18 Years -	University College, London
Interest of Indocyanine Green in Neoplastic Prostatic Tissue	NCT02260349	Prostatic Neopl...	indocyanine gre...	18 Years -	Centre Hospitalier Universitaire de Saint Etienne
Spectroscopic Analysis of Tongue Tumor Samples.	NCT05104619	Mass Spectrosco... Molecular Profi... Surgical Margin... Squamous Cell C... Oral Cavity Tongue	tongue surgery	18 Years -	Centre Hospitalier Universitaire, Amiens

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